1
|
Radulescu V, Boariu MI, Rusu D, Roman A, Surlin P, Voicu A, Didilescu AC, Jentsch H, Siciliano VI, Ramaglia L, Vela O, Kardaras G, Sculean A, Stratul SI. Clinical and microbiological effects of a single application of sodium hypochlorite gel during subgingival re-instrumentation: a triple-blind randomized placebo-controlled clinical trial. Clin Oral Investig 2022; 26:6639-6652. [PMID: 35829773 DOI: 10.1007/s00784-022-04618-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Accepted: 07/05/2022] [Indexed: 12/11/2022]
Abstract
OBJECTIVES The aim of this study is to assess the clinical and microbiological effects of a single subgingival administration of sodium hypochlorite gel (NaOCl) and compare it with 1% chlorhexidine (CHX) gel and a placebo gel following mechanical re-instrumentation during supportive periodontal therapy (SPT). MATERIALS AND METHODS Sixty-two patients who had been treated for stage III-IV periodontitis and enrolled in SPT were included in the study based on following criteria: (1) active periodontal therapy completed at least 6 months before enrollment in the study, (2) presence of at least 4 non-adjacent sites with probing pocket depths (PPDs) ≥ 4 mm with bleeding on probing (BOP), or presence of 5-8 mm PPDs with or without BOP. All sites presenting PPD ≥ 4 mm and BOP at baseline and 3-, 6-, and 9-month follow-up timepoints were subgingivally re-instrumented with ultrasounds. Selected patients were randomly assigned into three groups and treated additionally with a single subgingival administration of NaOCl gel (group A); 1% CHX gel (group B); and placebo gel (group C). Main outcome variable was pocket closure at 12 months. Secondary outcome variables were changes in mean PPD, BOP, and clinical attachment level (CAL) along with changes in the numbers of the following five keystone bacterial pathogens: Aggregatibacter actinomycetemcomitans (A.a.), Porphyromonas gingivalis (P.g.), Prevotella intermedia (P.i.), Tannerella forsythia (T.f.), and Treponema denticola (T.d.). RESULTS At 12 months, pocket closure was obtained in 77.5% in the NaOCl treated sites. The reduction in PPD was higher with CHX than with NaOCl, although a statistically significant adjunctive effect for NaOCl (P = 0.028) was only observed in comparison with placebo only. Mean CAL improved in all groups and at all timepoints, compared to the baseline (P < 0.05). However, after 6 months, CAL gain was statistically significantly higher in the NaOCl treated group than following application of CHX (P = 0.0026). CONCLUSION In SPT patients, a single adjunctive use of a NaOCl gel may provide benefits in controlling inflammation and residual pockets. TRIAL REGISTRATION ISRCTN Registry of Clinical Trials (ISRCTN11387188). CLINICAL RELEVANCE A baseline single application of NaOCl gel in conjunction with mechanical debridement may achieve substantial pocket closure in patients enrolled in SPT; treatment time, cost, and applicability considerations should be taken into account when selecting this therapy.
Collapse
Affiliation(s)
- Viorelia Radulescu
- Department of Periodontology, Faculty of Dental Medicine, Anton Sculean Research Center for Periodontal and Peri-Implant Diseases, Victor Babes University of Medicine and Pharmacy, , Timisoara, Romania
| | - Marius Ion Boariu
- Department of Endodontics, Faculty of Dental Medicine, TADERP Research Center, Victor Babes University of Medicine and Pharmacy, Timisoara, Romania.
| | - Darian Rusu
- Department of Periodontology, Faculty of Dental Medicine, Anton Sculean Research Center for Periodontal and Peri-Implant Diseases, Victor Babes University of Medicine and Pharmacy, , Timisoara, Romania
| | - Alexandra Roman
- Department of Periodontology, Faculty of Dental Medicine, Applicative Periodontal Regeneration Research Unit, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj Napoca, Romania
| | - Petra Surlin
- Department of Periodontology, Faculty of Dental Medicine, University of Medicine and Pharmacy, Craiova, Romania
| | - Adrian Voicu
- Department of Informatics and Medical Biostatistics, Victor Babes University of Medicine and Pharmacy, Timisoara, Romania
| | - Andreea Cristiana Didilescu
- Department of Embryology, Faculty of Dental Medicine, Carol Davila University of Medicine and Pharmacy, Bucuresti, Romania
| | - Holger Jentsch
- Department of Cariology, Endodontology and Periodontology, Centre for Periodontology, University Hospital of Leipzig, Leipzig, Germany
| | - Vincenzo Iorio Siciliano
- Department of Periodontology, School of Dental Medicine, University of Naples Federico II, Naples, Italy
| | - Luca Ramaglia
- Department of Periodontology, School of Dental Medicine, University of Naples Federico II, Naples, Italy
| | - Octavia Vela
- Department of Periodontology, Faculty of Dental Medicine, Anton Sculean Research Center for Periodontal and Peri-Implant Diseases, Victor Babes University of Medicine and Pharmacy, , Timisoara, Romania
| | - Giorgios Kardaras
- Department of Periodontology, Faculty of Dental Medicine, Anton Sculean Research Center for Periodontal and Peri-Implant Diseases, Victor Babes University of Medicine and Pharmacy, , Timisoara, Romania
| | - Anton Sculean
- Department of Periodontology, University of Bern, Bern, Switzerland
| | - Stefan-Ioan Stratul
- Department of Periodontology, Faculty of Dental Medicine, Anton Sculean Research Center for Periodontal and Peri-Implant Diseases, Victor Babes University of Medicine and Pharmacy, , Timisoara, Romania
| |
Collapse
|
2
|
Probiotics-Containing Mucoadhesive Gel for Targeting the Dysbiosis Associated with Periodontal Diseases. Int J Dent 2022; 2022:5007930. [PMID: 35265133 PMCID: PMC8898886 DOI: 10.1155/2022/5007930] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2021] [Revised: 01/18/2022] [Accepted: 01/28/2022] [Indexed: 02/07/2023] Open
Abstract
Objective Periodontitis is a common disorder that leads to the loss of both tooth and personal well-being, contributing to worsen the risk for metabolic and cardiovascular diseases. Recently, probiotics, characterized by rapid oral dispersion, have been topically used. Here, we present data of a mucoadhesive gel containing probiotics, capable of ensuring a slow release of bacteria to prevent and treat periodontitis. Methods An original mucoadhesive gel (AL0005) that is anhydrous and of food grade, loaded with the blend of lactobacilli and plants' dry extracts, has been assayed. Results The release kinetics of the bacterial mixture in different experimental models in vitro, including simulated saliva or physiological solutions, showed a significant and stable release for 5–8 hours. In one in vivo study of a mouse model of periodontitis, a locally applied mucoadhesive gel enriched with probiotic strains improved significantly the tissue pathology when compared with vehicle-exposed mice. Conclusions Together, the results suggest that this mucoadhesive gel can be useful in the normalization of the gum bacterial flora and improvement of the tissue pathology of gum disorders.
Collapse
|
3
|
Chen N, Ren R, Wei X, Mukundan R, Li G, Xu X, Zhao G, Zhao Z, Lele SM, Reinhardt RA, Wang D. Thermoresponsive Hydrogel-Based Local Delivery of Simvastatin for the Treatment of Periodontitis. Mol Pharm 2021; 18:1992-2003. [PMID: 33754729 DOI: 10.1021/acs.molpharmaceut.0c01196] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Except for routine scaling and root planing, there are few effective nonsurgical therapeutic interventions for periodontitis and associated alveolar bone loss. Simvastatin (SIM), one of the 3-hydroxy-3-methylglutaryl-cosenzyme A reductase inhibitors, which is known for its capacity as a lipid-lowering medication, has been proven to be an effective anti-inflammatory and bone anabolic agent that has shown promising benefits in mitigating periodontal bone loss. The local delivery of SIM into the periodontal pocket, however, has been challenging due to SIM's poor water solubility and its lack of osteotropicity. To overcome these issues, we report a novel SIM formulation of a thermoresponsive, osteotropic, injectable hydrogel (PF127) based on pyrophosphorolated pluronic F127 (F127-PPi). After mixing F127-PPi with F127 at a 1:1 ratio, the resulting PF127 was used to dissolve free SIM to generate the SIM-loaded formulation. The thermoresponsive hydrogel's rheologic behavior, erosion and SIM release kinetics, osteotropic property, and biocompatibility were evaluated in vitro. The therapeutic efficacy of SIM-loaded PF127 hydrogel on periodontal bone preservation and inflammation resolution was validated in a ligature-induced periodontitis rat model. Given that SIM is already an approved medication for hyperlipidemia, the data presented here support the translational potential of the SIM-loaded PF127 hydrogel for better clinical management of periodontitis and associated pathologies.
Collapse
Affiliation(s)
- Ningrong Chen
- Department of Pharmaceutical Sciences, College of Pharmacy, University of Nebraska Medical Center, 986125 Nebraska Medical Center, PDD 3020, Omaha, Nebraska 68198-6125, United States
| | - Rongguo Ren
- Department of Pharmaceutical Sciences, College of Pharmacy, University of Nebraska Medical Center, 986125 Nebraska Medical Center, PDD 3020, Omaha, Nebraska 68198-6125, United States
| | - Xin Wei
- Department of Pharmaceutical Sciences, College of Pharmacy, University of Nebraska Medical Center, 986125 Nebraska Medical Center, PDD 3020, Omaha, Nebraska 68198-6125, United States
| | - Roshni Mukundan
- Department of Pharmaceutical Sciences, College of Pharmacy, University of Nebraska Medical Center, 986125 Nebraska Medical Center, PDD 3020, Omaha, Nebraska 68198-6125, United States
| | - Guojuan Li
- Department of Pharmaceutical Sciences, College of Pharmacy, University of Nebraska Medical Center, 986125 Nebraska Medical Center, PDD 3020, Omaha, Nebraska 68198-6125, United States
| | - Xiaoke Xu
- Department of Pharmaceutical Sciences, College of Pharmacy, University of Nebraska Medical Center, 986125 Nebraska Medical Center, PDD 3020, Omaha, Nebraska 68198-6125, United States
| | - Gang Zhao
- Department of Pharmaceutical Sciences, College of Pharmacy, University of Nebraska Medical Center, 986125 Nebraska Medical Center, PDD 3020, Omaha, Nebraska 68198-6125, United States
| | - Zhifeng Zhao
- Department of Pharmaceutical Sciences, College of Pharmacy, University of Nebraska Medical Center, 986125 Nebraska Medical Center, PDD 3020, Omaha, Nebraska 68198-6125, United States
| | - Subodh M Lele
- Department of Pathology & Microbiology, College of Medicine, University of Nebraska Medical Center, Omaha, Nebraska 68198, United States
| | - Richard A Reinhardt
- Department of Surgical Specialties, College of Dentistry, University of Nebraska Medical Center, Lincoln, Nebraska 68583, United States
| | - Dong Wang
- Department of Pharmaceutical Sciences, College of Pharmacy, University of Nebraska Medical Center, 986125 Nebraska Medical Center, PDD 3020, Omaha, Nebraska 68198-6125, United States
| |
Collapse
|
4
|
Mahmood HT, Fatima F, Fida M, Sukhia RH, Irfan S, Malik D, Younus A, Afzal E. Effectiveness of metronidazole gel and mobile telephone short-message service reminders on gingivitis in orthodontic patients. Angle Orthod 2021; 91:220-226. [PMID: 33378447 DOI: 10.2319/052920-490.1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Accepted: 10/01/2020] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVES To compare the effectiveness of metronidazole gel and mobile telephone short-message service (SMS) reminders on gingivitis in patients undergoing fixed orthodontic treatment. MATERIALS AND METHODS The trial was double blinded (patient and investigator), and only the clinical trial unit pharmacist was unblinded. Data were collected from patients undergoing fixed orthodontic treatment for at least 6 months. A total of 66 patients were randomly assigned to either 0.8% metronidazole gel (n = 22), SMS reminder and placebo gel (n = 22), or placebo (control) group only (n = 22). Gingival index (GI), bleeding index (BI), and orthodontic plaque index (OPI) were evaluated on several teeth at baseline (T0) and after 4 weeks (T1). Paired-sample t-tests were used to compare mean differences of indexes at T0 and T1 in the groups, and independent-sample t-tests were used to determine the effects of interventions compared with the controls. RESULTS Data from 64 patients were analyzed; there were 2 dropouts. There were statistically significant (P < .05) reductions in GI, BI, and OPI scores from T0 to T1 for each intervention. However, there were no significant differences between each intervention and the control group. There were no adverse effects. CONCLUSIONS The null hypothesis could not be rejected. There is no difference between interventions (application of 0.8% metronidazole gel and SMS reminder for reinforcing oral hygiene) in reducing gingival inflammation in orthodontic patients.
Collapse
|
5
|
Zhao H, Hu J, Zhao L. Adjunctive subgingival application of Chlorhexidine gel in nonsurgical periodontal treatment for chronic periodontitis: a systematic review and meta-analysis. BMC Oral Health 2020; 20:34. [PMID: 32005169 PMCID: PMC6995104 DOI: 10.1186/s12903-020-1021-0] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Accepted: 01/23/2020] [Indexed: 01/27/2023] Open
Abstract
Background Subgingival applications of chlorhexidine (CHX) gel are commonly used as an adjunct in nonsurgical periodontal treatment (NSPT) for chronic periodontitis (CP). However, there is lack of systematic review and meta-analysis justifying the effects of adjunctive CHX gel on clinical outcomes. The objective of this meta-analysis was to evaluate the efficacy of adjunctive subgingival administration of CHX gel in NSPT compared to NSPT alone for CP. Methods An electronic search of four databases and a manual search of four journals were conducted up to August 2019. Only randomized controlled trials reporting on the clinical outcomes of subgingival use of CHX gel adjunct to scaling and root planing (SRP), as compared to SRP alone or with placebo, for at least 3 months were included. Primary outcomes were probing pocket depth (PPD) reduction and clinical attachment level (CAL) gain at 3 and 6 months, when data on at least three studies were obtained. Results Seventeen studies were included for qualitative analysis and seven studies for quantitative analysis (four studies for the application of CHX gel adjunct to SRP at selected sites with at least pocket depth ≥ 4 mm and three studies for comparison of full-mouth disinfection (FMD) with subgingival use of CHX gel and full-mouth scaling and root planing (FMSRP). For subgroups, the clinical outcomes between adjunctive use of Xanthan-based CHX gel (XAN-CHX gel) and CHX gel were analyzed. Results indicated a significant improvement of PPD reduction following local adjunctive administration of XAN-CHX gel for SRP at selected sites (MD: 0.15 mm). However, no difference was found in CAL gain. Moreover, no significant difference was observed in PPD and CAL at both 3 and 6 months post-treatment between FMD and FMSRP. Conclusion Adjunctive subgingival administration of XAN-CHX gel at individual selected sites in NSPT appears to provide slight benefits in PPD reduction compared to NSPT alone for CP. Due to the lack of high-quality studies, further studies with larger sample sizes and strict standards are needed to confirm the conclusions.
Collapse
Affiliation(s)
- Han Zhao
- Multi-disciplinary Treatment Center, Beijing Stomatological Hospital, School of Stomatology, Capital Medical University, Tian Tan Xi Li Number.4, Beijing, 100050, China.,Department of Periodontology, Witten/Herdecke, University, Alfred-Herrhausen-Str. 45, 58445, Witten, Germany
| | - Jingchao Hu
- Department of Periodontology, Witten/Herdecke, University, Alfred-Herrhausen-Str. 45, 58445, Witten, Germany.,Department of Periodontics, Beijing Stomatological Hospital, School of Stomatology, Capital Medical University, Tian Tan Xi Li Number 4, Beijing, 100050, China
| | - Li Zhao
- Department of Prosthodontics, Stomatological Hospital of Chongqing Medical University, Chongqing, 400015, China. .,Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, 400015, China. .,Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, 400015, China.
| |
Collapse
|
6
|
Clinical effects of 2% chlorhexidine gel on patients undergoing orthodontic treatment. ACTA ACUST UNITED AC 2019. [DOI: 10.1016/j.odw.2008.07.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
|
7
|
Reddy PRT, Vandana KV, Prakash S. Antibacterial and anti-inflammatory properties of Plantago ovata Forssk. leaves and seeds against periodontal pathogens: An in vitro study. Ayu 2019; 39:226-229. [PMID: 31367145 PMCID: PMC6639823 DOI: 10.4103/ayu.ayu_176_16] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Background: Plantago commonly called as Isabgol (Plantago ovata Forssk.) is a perennial herb that belongs to the family Plantaginaceae. A range of biological activities has been found from plant extracts, including wound healing activity, anti-inflammatory, analgesic, antioxidant, weak antibiotic, immunomodulating and anti-ulcerogenic activity. Periodontal disease is a complex condition as a result of interaction between microorganisms and host inflammatory mediators. Hence, the extract of Isabgol is tested for its antibacterial and anti-inflammatory properties against periodontal disease. Aim: The aim of this in vitro study is to evaluate the antibacterial property of Isabgol leaves and seeds against periodontal pathogens, namely Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Prevotella intermedia, and Fusobacterium nucleatum and anti-inflammatory property against matrix metalloproteinase-2 (MMP-2) and MMP-9. Materials and Methods: In this in vitro study, aqueous extract of Isabgol is tested for its antibacterial property against the stock cultures of specified periodontal pathogens using the tube dilution method and anti-inflammatory property against MMP-2 and MMP-9 using zymogen gel electrography. Results: Minimum concentration at which the sensitivity of A. actinomycetemcomitans, P. gingivalis, P. intermedia, and F. nucleatum for the extract observed was 50 μl/ml, 0.8 μl/ml, 0.4 μl/ml and 12.5 μl/ml, respectively, concentrations below these showed no effect on the microorganisms. Zymogen electrographic test for anti-inflammatory activity showed percentage inhibition of 30% and 40% against MMP-2 and MMP-9, respectively. Conclusion: Isabgol is effective against the periodontal pathogens and inflammatory mediators which are responsible for periodontal disease.
Collapse
Affiliation(s)
| | - K V Vandana
- Department of Periodontics, College of Dental Sciences, Davangere, Karnataka, India
| | - Shobha Prakash
- Department of Periodontics, College of Dental Sciences, Davangere, Karnataka, India
| |
Collapse
|
8
|
Batool F, Agossa K, Lizambard M, Petit C, Bugueno IM, Delcourt-Debruyne E, Benkirane-Jessel N, Tenenbaum H, Siepmann J, Siepmann F, Huck O. In-situ forming implants loaded with chlorhexidine and ibuprofen for periodontal treatment: Proof of concept study in vivo. Int J Pharm 2019; 569:118564. [PMID: 31352049 DOI: 10.1016/j.ijpharm.2019.118564] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Revised: 07/23/2019] [Accepted: 07/24/2019] [Indexed: 12/12/2022]
Abstract
Control of infection and inflammation is crucial for the success of periodontal treatment. In this study, in-situ forming implants (ISFI) loaded with chlorhexidine dihydrochloride (CHX) and ibuprofen (IBU) were developed and tested to optimize periodontal treatment outcomes. Release profiles were promising. Exposure to 1.5% and 5.3% CHX-IBU loaded ISFI's release media decreased significantly the P. gingivalis growth up to 20-fold and 35-fold, respectively, after 48 h (p < 0.05). The metabolic activity assay of gingival epithelial cells (EC) demonstrated 1.5% CHX-IBU-loaded ISFI to be non-toxic, therefore, it was selected for further experimentation. Furthermore, significant down-regulation of TNF-α release (34% at 6 h and 43% at 24 h, p < 0.05) in P. gingivalis lipopolysaccharide (Pg-LPS) stimulated EC exposed to 1.5% CHX-IBU ISFI release medium was demonstrated by ELISA. In vivo, 1.5% CHX-IBU ISFI was injected into the periodontal pocket in an experimental periodontitis mouse model and the reduction in inflammation and improvement in periodontal wound healing was evaluated through inflammatory cell scoring and histomorphometry at 7- and 15-days post-treatment. The results indicate that CHX-IBU loaded ISFI could be efficient as adjuvant to periodontal therapy for the control of infection and inflammation. Moreover, other (e.g., pro-regenerative) drugs could be incorporated into ISFI to further improve periodontal treatment outcomes.
Collapse
Affiliation(s)
- Fareeha Batool
- INSERM (French National Institute of Health and Medical Research), UMR 1260, Regenerative Nanomedicine, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Strasbourg, France; Université de Strasbourg, Faculté de Chirurgie-dentaire, 8 rue Sainte-Elisabeth, 67000 Strasbourg, France
| | - Kevimy Agossa
- Univ. Lille, Inserm, CHU Lille, U1008 - Controlled Drug Delivery Systems and Biomaterials, F-59000 Lille, France
| | - Martin Lizambard
- Univ. Lille, Inserm, CHU Lille, U1008 - Controlled Drug Delivery Systems and Biomaterials, F-59000 Lille, France
| | - Catherine Petit
- INSERM (French National Institute of Health and Medical Research), UMR 1260, Regenerative Nanomedicine, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Strasbourg, France; Université de Strasbourg, Faculté de Chirurgie-dentaire, 8 rue Sainte-Elisabeth, 67000 Strasbourg, France
| | - Isaac Maximiliano Bugueno
- INSERM (French National Institute of Health and Medical Research), UMR 1260, Regenerative Nanomedicine, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Strasbourg, France; Université de Strasbourg, Faculté de Chirurgie-dentaire, 8 rue Sainte-Elisabeth, 67000 Strasbourg, France
| | - Elisabeth Delcourt-Debruyne
- Univ. Lille, Inserm, CHU Lille, U1008 - Controlled Drug Delivery Systems and Biomaterials, F-59000 Lille, France
| | - Nadia Benkirane-Jessel
- INSERM (French National Institute of Health and Medical Research), UMR 1260, Regenerative Nanomedicine, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Strasbourg, France
| | - Henri Tenenbaum
- INSERM (French National Institute of Health and Medical Research), UMR 1260, Regenerative Nanomedicine, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Strasbourg, France; Université de Strasbourg, Faculté de Chirurgie-dentaire, 8 rue Sainte-Elisabeth, 67000 Strasbourg, France
| | - Juergen Siepmann
- Univ. Lille, Inserm, CHU Lille, U1008 - Controlled Drug Delivery Systems and Biomaterials, F-59000 Lille, France
| | - Florence Siepmann
- Univ. Lille, Inserm, CHU Lille, U1008 - Controlled Drug Delivery Systems and Biomaterials, F-59000 Lille, France
| | - Olivier Huck
- INSERM (French National Institute of Health and Medical Research), UMR 1260, Regenerative Nanomedicine, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Strasbourg, France; Université de Strasbourg, Faculté de Chirurgie-dentaire, 8 rue Sainte-Elisabeth, 67000 Strasbourg, France.
| |
Collapse
|
9
|
Vitt A, Gustafsson A, Ramberg P, Slizen V, Kazeko LA, Buhlin K. Polyhexamethylene guanidine phosphate irrigation as an adjunctive to scaling and root planing in the treatment of chronic periodontitis. Acta Odontol Scand 2019; 77:290-295. [PMID: 30632852 DOI: 10.1080/00016357.2018.1541099] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
OBJECTIVE To evaluate the efficacy of adjunctive polyhexamethylene guanidine (PHMG) phosphate irrigation in periodontal treatment. MATERIALS AND METHODS The subjects comprised 59 patients with severe chronic periodontitis. Plaque index, bleeding on probing (BOP) and pocket probing depths (PPD) were recorded. The subjects were randomly allocated to one of three groups for scaling and root planning, with different adjunctive irrigants: 1% PHMG phosphate (19 subjects), 0.2% chlorhexidine (21 subjects) and distilled water (19 subjects). Patients were recalled after two weeks, one month and then after 4, 6 and 12 months. RESULTS In all groups, treatment resulted in considerable improvement of the observed clinical parameters. There were no intergroup differences in plaque index and BOP at any time point, but significant differences in PPD at one, four and six months. By the end of the study no intergroup differences in PPDs persisted. While post study surgical treatment needs decreased in all three groups, no intergroup differences were observed in the number of deep periodontal pockets. CONCLUSIONS Irrigation with PHMG phosphate significantly reduces PPDs in the short-term, but has no significant long-term effect on the mean pocket depth.
Collapse
Affiliation(s)
- Anton Vitt
- Division of Periodontology, Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden
- 1st Department of Therapeutic Dentistry, Belarusian State Medical University, Belarus
| | - Anders Gustafsson
- Division of Periodontology, Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden
| | - Per Ramberg
- Department of Periodontology, Institute of Odontology, the Sahlgrenska Academy at Gothenburg University, Sweden
| | - Veronica Slizen
- Department of Microbiology, Virology and Immunology, Belarusian State Medical University, Belarus
| | - Lyudmila A. Kazeko
- 1st Department of Therapeutic Dentistry, Belarusian State Medical University, Belarus
| | - Kåre Buhlin
- Division of Periodontology, Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden
| |
Collapse
|
10
|
Boonlai W, Tantishaiyakul V, Hirun N, Sangfai T, Suknuntha K. Thermosensitive Poloxamer 407/Poly(Acrylic Acid) Hydrogels with Potential Application as Injectable Drug Delivery System. AAPS PharmSciTech 2018; 19:2103-2117. [PMID: 29696613 DOI: 10.1208/s12249-018-1010-7] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2018] [Accepted: 04/03/2018] [Indexed: 12/26/2022] Open
Abstract
Thermosensitive hydrogels are of great interest for in situ gelling drug delivery. The thermosensitive vehicle with a gelation temperature in a range of 30-36°C would be convenient to be injected as liquid and transform into gel after injection. To prepare novel hydrogels gelling near body temperature, the gelation temperature of poloxamer 407 (PX) were tailored by mixing PX with poly(acrylic acid) (PAA). The gelation behaviors of PX/PAA systems as well as the interaction mechanism were investigated by tube inversion, viscoelastic, shear viscosity, DSC, SEM, and FTIR studies. The gelation temperature of the plain PX solutions at high concentration of 18, 20, and 22% (w/w) gelled at temperature below 28°C, which is out of the suitable temperature range. Mixing PX with PAA to obtain 18 and 20% (w/w) PX with 1% (w/w) PAA increased the gelation temperature to the desired temperature range of 30-36°C. The intermolecular entanglements and hydrogen bonds between PX and PAA may be responsible for the modulation of the gelation features of PX. The mixtures behaved low viscosity liquid at room temperature with shear thinning behavior enabling their injectability and rapidly gelled at body temperature. The gel strength increased, while the pore size decreased with increasing PX concentration. Metronidazole, an antibiotic used for periodontitis, was incorporated into the matrices, and the drug did not hinder their gelling ability. The gels showed the sustained drug release characteristic. The thermosensitive PX/PAA hydrogel could be a promising injectable in situ gelling system for periodontal drug delivery.
Collapse
|
11
|
Bogdanovska L, Poceva Panovska A, Popovska M, Dimitrovska A, Petkovska R. Chemometric evaluation of the efficacy of locally administered chlorhexidine in patients with periodontal disease. Saudi Pharm J 2017; 25:1022-1031. [PMID: 29158711 PMCID: PMC5681301 DOI: 10.1016/j.jsps.2017.03.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2016] [Revised: 01/31/2017] [Accepted: 03/24/2017] [Indexed: 12/02/2022] Open
Abstract
The process of assessment of drug efficacy produces multivariate data which are difficult to interpret. The interpretation and extraction of relevant data requires application of chemometric algorithms for multivariate data analysis. The aim of our study was evaluation of the efficacy of local treatment with chlorhexidine (CHX) in patients suffering from periodontal disease by chemometric algorithms for multivariate data analysis. Several algorithms were used: principal component analysis (PCA), partial least squares discriminant analysis (PLS-DA) and orthogonal projection to latent structures discriminant analysis (OPLS-DA). The PCA models identified the examined variables as suitable for monitoring the periodontal disease progression at the same time revealing mutual relationship among them. The developed PLS-DA model successfully distinguished patients treated with CHX from non-treated patients. The OPLS-DA model revealed differences in the mechanism of action of the two widely applied treatments in periodontal disease, local administration of CHX and local administration of doxycycline (DOX). The approach presented in this study opens the possibility of application of chemometric algorithms for multivariate data analysis for assessment of treatment efficacy.
Collapse
Key Words
- ALP, alkaline phosphatase
- AST, aspartate aminotransferase
- CAL, clinical attachment loss
- CHX, chlorhexidine
- Chemometric algorithms
- Chlorhexidine
- DOX, doxycycline
- GCF, gingival crevicular fluid
- GI, index of gingival inflammation
- IL-1β, interleukin -1 beta
- LDH, lactate dehydrogenase
- Multivariate data analysis
- OPLS-DA, orthogonal projection to latent structures discriminant analysis
- PCA, principal component analysis
- PD, pocket depth
- PLS-DA, partial least square discriminant analysis
- Periodontal disease
- TNF, α- tumor necrosis factor-alpha
- Treatment efficacy
- VIP, variable influence on projection
Collapse
Affiliation(s)
- Liljana Bogdanovska
- Institute of Applied Chemistry and Pharmaceutical Analysis, Faculty of Pharmacy, University of Ss. Cyril and Methodius, Majka Teresa 47, 1000 Skopje, Macedonia
- Corresponding author at: Faculty of Pharmacy, Univ. Ss Cyril and Methodius, Majka Teresa 47, POB 36, 1000 Skopje, Macedonia.Faculty of PharmacyUniv. Ss Cyril and MethodiusMajka Teresa 47POB 361000 SkopjeMacedonia
| | - Ana Poceva Panovska
- Institute of Applied Chemistry and Pharmaceutical Analysis, Faculty of Pharmacy, University of Ss. Cyril and Methodius, Majka Teresa 47, 1000 Skopje, Macedonia
| | - Mirjana Popovska
- Department of Oral Pathology and Periodontology, Faculty of Dentistry, University of Ss. Cyril and Methodius, Majka Teresa 47, 1000 Skopje, Macedonia
| | - Aneta Dimitrovska
- Institute of Applied Chemistry and Pharmaceutical Analysis, Faculty of Pharmacy, University of Ss. Cyril and Methodius, Majka Teresa 47, 1000 Skopje, Macedonia
| | - Rumenka Petkovska
- Institute of Applied Chemistry and Pharmaceutical Analysis, Faculty of Pharmacy, University of Ss. Cyril and Methodius, Majka Teresa 47, 1000 Skopje, Macedonia
| |
Collapse
|
12
|
Faramarzi M, Shirmohammadi A, Chitsazi M, Shamami MS, Ghanitab S. The clinical and metabolic effects of subgingival application of xanthan-based chlorhexidine gel in Type 2 diabetic patients with chronic periodontitis. Dent Res J (Isfahan) 2017; 14:299-305. [PMID: 29109743 PMCID: PMC5654223 DOI: 10.4103/1735-3327.215961] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
Background: There is a two-way relationship between periodontal disease and diabetes. The purpose of this study was to evaluate the clinical and metabolic effects of a xanthan-based chlorhexidine (CHX) gel used as an adjunct to nonsurgical periodontal therapy in Type II diabetic patients with chronic periodontitis. Materials and Methods: Sixty-eight diabetic patients with moderate to advanced periodontitis and glycated hemoglobin (HbA1c) ≥6% were selected. The test group (n = 34) received scaling and root planning (SRP) plus xanthan-based CHX gel. The control group (n = 34) received single SRP. Fasting blood sugar (FBS) and HbA1c tests were done at the baseline and after 3 and 6 months. Data from the study were analyzed using descriptive statistics (mean ± standard deviation and frequency), ANOVA test by SPSS.15 software (SPSS Inc. Chicago, IL, USA). P < 0.05 was considered statistically significant. Results: Patients in test group exhibited a decrease in FBS from the baseline (227 ± 64.97) to the 3 and 6 months follow-up (208 ± 61.95 and 201 ± 61.33; P < 0.001). HbA1cb levels decreased from 7.72 ± 0.99 to 6.20 ± 0.97 and 6.06 ± 1.04 after 3 and 6 months follow-up (P < 0.001), respectively. Reduction of FBS and HbA1c was statistically significant after 3 and 6 months in the control group (P < 0.001). Conclusion: Considering the limitations of this study, the application of CHX gel might improve the effects of nonsurgical periodontal treatment in diabetic patients with periodontitis.
Collapse
Affiliation(s)
- Masoumeh Faramarzi
- Department of Periodontics and Dental and Periodontal Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Adileh Shirmohammadi
- Department of Periodontics and Dental and Periodontal Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mohammadtaghi Chitsazi
- Department of Periodontics and Dental and Periodontal Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mehrnoosh Sadighi Shamami
- Department of Periodontics and Dental and Periodontal Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | | |
Collapse
|
13
|
Hugar SS, Patil S, Metgud R, Nanjwade B, Hugar SM. Influence of application of chlorhexidine gel and curcumin gel as an adjunct to scaling and root planing: A interventional study. J Nat Sci Biol Med 2016; 7:149-54. [PMID: 27433065 PMCID: PMC4934104 DOI: 10.4103/0976-9668.184701] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background: Currently, the most common therapy for periodontal diseases consists of professional scaling and root planing (SRP). However, it was found to be of limited efficacy especially in areas which are inaccessible to periodontal instrumentation. Therefore, treatment strategies using antimicrobials in conjunction with conventional therapy have evolved. Thus, the study was undertaken with an. Aim: To evaluate the efficacy of application of chlorhexidine gel and curcumin gel as an adjunct to SRP. Materials and Methods: The study was conducted on thirty chronic periodontitis patients who were divided into two groups as control and experimental groups using a split-mouth design. After SRP chlorhexidine gel was applied in control and curcumin gel in experimental groups. The plaque index, gingival index, sulcus bleeding index, probing pocket depth were recorded at baseline and subsequently after 1 month and 45 days. Results: The results revealed that both chlorhexidine gel and curcumin gel have an effect on mild to moderate periodontal pockets in chronic periodontitis patients, but greater reduction was observed in the experimental group than the control group. Conclusion: It can be concluded that both control and experimental gel can be used as an adjunct to SRP, but the curcumin gel was more effective than the chlorhexidine gel in the treatment of mild to moderate periodontal pockets with a significant reduction in the indice scores when compared to the baseline values.
Collapse
Affiliation(s)
- Shweta S Hugar
- Department of Periodontics, KLE VK Institute of Dental Sciences, KLE University, Belgaum, Karnataka, India
| | - Suvarna Patil
- Department of Periodontics, Maratha Mandal's NGH Institute of Dental Sciences, Belgaum, Karnataka, India
| | - Renuka Metgud
- Department of Periodontics, KLE VK Institute of Dental Sciences, Belgaum, Karnataka, India
| | - Basavraj Nanjwade
- Department of Pharmaceutics, KLES College of Pharmacy, Belgaum, Karnataka, India
| | - Shivayogi M Hugar
- Department of Pedodontics and Preventive Dentistry, KLE VK Institute of Dental Sciences, Belgaum, Karnataka, India
| |
Collapse
|
14
|
Agrawal N, Kundu D, Agrawal K, Singhal A. Comparison of longitudinal changes in clinical periodontal parameters of canines and first molars treated with fixed orthodontic appliances. Am J Orthod Dentofacial Orthop 2016; 149:325-30. [PMID: 26926019 DOI: 10.1016/j.ajodo.2015.07.041] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2015] [Revised: 07/01/2015] [Accepted: 07/01/2015] [Indexed: 11/17/2022]
Abstract
INTRODUCTION Our objective was to learn the possible effects of fixed orthodontic therapy on the periodontium of the extraction sites adjacent to canines and first molars. This was a prospective cohort study. METHODS Sixty-two systemically healthy subjects were selected. The study was divided into the period of oral hygiene instructions and the period of active orthodontic treatment. Plaque index, gingival index, probing pocket depth, and clinical attachment loss were recorded for the canines and first molars at baseline, after 1 month of orthodontic therapy, and every 3 months until the completion of the orthodontic treatment. RESULTS There was a statistically significant increase in all clinical parameters (plaque index, gingival index, probing pocket depth, and attachment loss; P <0.05) on the first molars compared with the canines. Significant increases in attachment loss were noted in both the canines (baseline, 0.06 ± 0.01 mm; end of treatment, 0.17 ± 0.02 mm) and the molars (baseline, 0.07 ± 0.01 mm; end of treatment, 0.20 ± 0.02 mm). CONCLUSIONS Attachment loss cannot be explained solely by the effect of plaque or the banding of teeth. Other factors such as tooth extractions adjacent to the canines, tooth movement, and occlusal trauma may have contributing roles in the loss of periodontal support in adolescent patients.
Collapse
Affiliation(s)
- Neeraj Agrawal
- Reader, Department of Periodontology, People's Dental Academy, Bhopal, India.
| | - Debabrata Kundu
- Professor and head, Department of Periodontology, Dr. R. Ahmed Dental College and Hospital, Kolkata, India
| | - Kavita Agrawal
- Reader, Department of Oral Medicine Diagnosis and Radiology, People's College of Dental Sciences and Research Centre, Kolkata, India
| | - Ankit Singhal
- Reader, Department of Orthodontics, Vananchal Dental College and Hospital, Garwha, India
| |
Collapse
|
15
|
Pain Perception and Anxiety Levels during Menstrual Cycle Associated with Periodontal Therapy. Int J Dent 2014; 2014:472926. [PMID: 25371677 PMCID: PMC4209788 DOI: 10.1155/2014/472926] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2014] [Accepted: 09/25/2014] [Indexed: 11/22/2022] Open
Abstract
Objectives. To compare the pain perception and anxiety levels of female patients undergoing scaling and root planing during menstrual (perimenstrual) period with those observed during postmenstrual period. Materials and Methods. This was a single blind study, with a split-mouth design. Forty-four women with chronic periodontitis with regular menstrual cycles were subjected to complete Corah's Dental Anxiety Scale (DAS) during their first debridement visit. Patients were randomly selected to undergo their first debridement visit during either their menstrual or postmenstrual period. Scaling was performed under local anesthesia in bilateral quadrants of patients during the periods. Visual Analogue Scale (VAS) was used to score pain levels for each quadrant after performing scaling and root planing. Results. Increase in pain perception among females during their menstrual or perimenstrual period was significantly greater than their postmenstrual period (P < 0.05). It is observed that women whose first appointment was given in perimenstrual period had more pain (VAS) (P = 0.0000) when compared to those women whose first appointment was given in postmenstrual period. Conclusion. Females in their menstrual period demonstrated higher pain responses and high anxiety levels to supra- and subgingival debridement. This increase in the pain levels of women during their menstrual period was statistically significant. If the appointments are given in postmenstrual period, women feel less pain.
Collapse
|
16
|
Shetty S, Thomas B, Shetty V, Bhandary R, Shetty RM. An in-vitro evaluation of the efficacy of garlic extract as an antimicrobial agent on periodontal pathogens: A microbiological study. Ayu 2014; 34:445-51. [PMID: 24695825 PMCID: PMC3968712 DOI: 10.4103/0974-8520.127732] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
With the rise in bacterial resistance to antibiotics, there is considerable interest in the development of other classes of antimicrobials for the control of infection. Garlic (Allium sativum Linn.) has been used as medicine since ancient times and has long been known to have antibacterial, antifungal, and antiviral properties. This study was undertaken to assess the inhibitory effect of garlic on Porphyromonas gingivalis and Aggregatibacter actinomycetemcomitans, to assess the time-kill curve of P. gingivalis and A. actinomycetemcomitans, and to determine the antiproteolytic activity of garlic on P. gingivalis. Ethanolic garlic extract (EGE) and aqueous garlic extract (AGE) were prepared and the inhibitory effects of these extracts for two periodontal pathogens (P. gingivalis and A. actinomycetemcomitans) were tested. Antiproteolytic activity on protease of P. gingivalis was determined. 25 microliter (μl), 50 μl, and 75 μl of AGE showed 16 mm, 20 mm, and 25 mm zone of inhibition, respectively, on P. gingivalis. The AGE showed greater bacteriostatic activity against the P. gingivalis with minimum inhibitory concentration determined at 16.6 μl/ml. The time-kill assay of AGE and EGE were compared for P. gingivalis and A. actinomycetemcomitans. AGE showed better antiproteolytic activity on total protease of P. gingivalis compared to the EGE. Thus, the study concludes the antimicrobial activity of garlic extract against periodontal pathogens, P. gingivalis, A. actinomycetemcomitans. Its action against P. gingivalis includes inhibition of total protease activity, and this raises the possibility that garlic may have therapeutic use for periodontitis and possibly other oral infections.
Collapse
Affiliation(s)
- Sunaina Shetty
- Assistant Professor, Department of Periodontics, Chhattisgarh Dental College and Research Institute, Rajnandgaon, Chhattisgarh, India
| | - Biju Thomas
- Professor and Head, Department of Periodontics, A.B. Shetty Memorial Institute of Dental Sciences, Mangalore, Karnataka, India
| | - Veena Shetty
- Professor, Department of Microbiology, A.B. Shetty Memorial Institute of Dental Sciences, Mangalore, Karnataka, India
| | - Rahul Bhandary
- Professor, Department of Periodontics, A.B. Shetty Memorial Institute of Dental Sciences, Mangalore, Karnataka, India
| | - Raghavendra M Shetty
- Professor, Department of Pedodontics, Chhattisgarh Dental College and Research Institute, Rajnandgaon, Chhattisgarh, India
| |
Collapse
|
17
|
Jain M, Dave D, Jain P, Manohar B, Yadav B, Shetty N. Efficacy of xanthan based chlorhexidine gel as an adjunct to scaling and root planing in treatment of the chronic periodontitis. J Indian Soc Periodontol 2013; 17:439-43. [PMID: 24174721 PMCID: PMC3800404 DOI: 10.4103/0972-124x.118313] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2011] [Accepted: 07/21/2013] [Indexed: 11/09/2022] Open
Abstract
Aim: The aim of this study was to evaluate the clinical effectiveness of locally delivered xanthan-based Chlosite® gel as an adjunctive therapy to scaling and root planing in treatment of chronic periodontitis. Materials and Methods: In a randomized controlled clinical study, 30 patients were selected. Pocket depth between 5 and 7 mm was selected and each patient had two sites on the same side of the mouth. A total of 30 control sites were scaled and root planed and 30 test sites were scaled and root planed and Chlosite® gel was added. The clinical parameters, probing depth (PD), clinical attachment level (CAL), plaque index (PI) and bleeding on probing (BOP), gingival index were recorded at baseline, 6 weeks, 3 months and 6 months. Statistical Analysis: Paired/unpaired t-test was used, significance was placed at 5% level of significance, i.e., P < 0.05 was considered as a significant. Results: From baseline to a period of 6 months, significant difference was found between test and control group for PD, CAL, PI and BOP, P value being PD (P = 0.002), CAL index (P = 0.014), respectively. Conclusion: Subgingival injection of xanthan-based Chlosite® gel adjunct with scaling and root planing appeared to cause significant improvement compared with scaling and root planing alone in persons with chronic periodontitis.
Collapse
Affiliation(s)
- Meetu Jain
- Department of Periodontics, Pacific Dental College and Hospital, Vadodara, Gujarat, India
| | | | | | | | | | | |
Collapse
|
18
|
Puri K, Dodwad V, Bhat K, Puri N. Effect of controlled-release Periochip™ on clinical and microbiological parameters in patients of chronic periodontitis. J Indian Soc Periodontol 2013; 17:605-11. [PMID: 24174754 PMCID: PMC3808015 DOI: 10.4103/0972-124x.119299] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2012] [Accepted: 08/01/2013] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND The aim of the present study was to evaluate and compare the clinical and microbiological effectiveness of Periochip™ as an adjunct to scaling and root planing (SRP) with SRP alone in patients with chronic periodontitis. MATERIALS AND METHODS This randomized, split mouth, 3-month clinical and microbiological trial included 30 sites in 15 patients aged 30-50 years diagnosed with chronic periodontitis. In each patient, two bilateral pockets probing 5-7 mm were randomly assigned to test and control groups. The test group received SRP plus Periochip™, whereas the control group received SRP alone. Clinical indices and anaerobic culture analysis was done at baseline, 1 month, and 3 months interval. Total bacterial count and analysis of four major periodontopathogenic bacteria Porphyromonas gingivalis (Pg), Prevotella intermedia (Pi), Aggregatibacter actinomycetemcomitans (Aa), and Fusobacterium nucleatum (Fn) was done. RESULTS Significant improvement was obtained in all clinical variables in the test group as compared to the control group over the study period. Total colony counts were significantly reduced in the test group as compared to control over the period of time. At baseline Aa was recovered from 4 test group sites and 5 control group sites, Pg from 15 test group and 14 control group sites, Pi from 5 test group and 2 control group sites, Fn from 7 test and 7 control group sites. At 3 months, Aa was recovered from 1 test group and 4 control group sites, Pg from 4 test group and 8 control group sites, Pi from 1 test group and 1 control group site, Fn from 3 test and 4 control group sites. CONCLUSION Periochip™ placement as an adjunct to SRP, showed promising results, when compared to SRP alone. Healthy microflora can be maintained for a longer period of time and delay in the repopulation by periodontopathic microorganisms was observed.
Collapse
Affiliation(s)
- Komal Puri
- Department of Periodontics, Institute of Dental Studies and Technologies, Modinagar, India
| | - Vidya Dodwad
- Department of Periodontics, I.T.S Dental College, Muradnagar, Uttar Pradesh, India
| | - Kishore Bhat
- Department of Microbiology, Maratha Mandal Dental College, Belgaum, Karnataka, India
| | - Nikhil Puri
- Department of Endodontics, Institute of Dental Studies and Technologies, Modinagar, Uttar Pradesh, India
| |
Collapse
|
19
|
Ghijselings E, Coucke W, Verdonck A, Teughels W, Quirynen M, Pauwels M, Carels C, van Gastel J. Long-term changes in microbiology and clinical periodontal variables after completion of fixed orthodontic appliances. Orthod Craniofac Res 2013; 17:49-59. [DOI: 10.1111/ocr.12031] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/09/2013] [Indexed: 12/20/2022]
Affiliation(s)
- E. Ghijselings
- Department of Oral Health Sciences - Orthodontics; KU Leuven & Dentistry, University Hospitals Leuven; Belgium
| | - W. Coucke
- Department of Orthodontics and Craniofacial Biology; Radboud University Nijmegen Medical Centre; Nijmegen The Netherlands
| | - A. Verdonck
- Department of Oral Health Sciences - Orthodontics; KU Leuven & Dentistry, University Hospitals Leuven; Belgium
| | - W. Teughels
- Department of Oral Health Sciences - Periodontology; KU Leuven & Dentistry, University Hospitals Leuven; Belgium
| | - M. Quirynen
- Department of Oral Health Sciences - Periodontology; KU Leuven & Dentistry, University Hospitals Leuven; Belgium
| | - M. Pauwels
- Department of Oral Health Sciences - Periodontology; KU Leuven & Dentistry, University Hospitals Leuven; Belgium
| | - C. Carels
- Department of Oral Health Sciences - Orthodontics; KU Leuven & Dentistry, University Hospitals Leuven; Belgium
- Department of Quality of Medical Laboratories; Scientific Institute of Public Health; Brussels Belgium
| | - J. van Gastel
- Department of Oral Health Sciences - Orthodontics; KU Leuven & Dentistry, University Hospitals Leuven; Belgium
| |
Collapse
|
20
|
Abstract
The reported prevalence of dentine/root (hyper)sensitivity (DH/RS) in the published literature varies, and this may be due in part to a) the different study populations and (b) the different methodologies employed in evaluating the pain response. According to von Troil et al. (2002) there are limited data available in terms of the prevalence and intensity of DH/RS following periodontal therapy. Objectives. The aim of the present study was therefore to review the literature in order to identify all relevant studies for inclusion and to determine whether there was any evidence of DH/RS following periodontal procedures in the published literature up to 31st December 2009 using an agreed search protocol. Methods. 840 papers were identified, from searching both electronic databases (PUBMED) and hand searching of relevant written journals. Twelve papers were subsequently accepted for inclusion. Results. The results of the present study would indicate that the reported prevalence for DH/RS (following nonsurgical therapy) was between 62.5% and 90% one day after treatment decreasing to approximately 52.6% to 55% after one week. The prevalence of DH/RS following surgical therapy was between 76.8% and 80.4% one day after treatment subsequently decreasing over time to 36.8% after 1 week, 33.4% after 2 weeks, 29.6% after 4 weeks, and 21.7% after 8 weeks. Conclusions. It is evident from reviewing the included studies that patients may suffer from mild discomfort following periodontal procedures although both the prevalence and intensity of DH/RS may vary depending on the duration and the type of procedure involved. Most of the studies included in this paper would tend to suggest that DH/RS may be relatively mild/moderate in nature and transient in duration.
Collapse
|
21
|
Postoperative pain after root canal treatment: a prospective cohort study. Int J Dent 2012; 2012:310467. [PMID: 22505897 PMCID: PMC3312224 DOI: 10.1155/2012/310467] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2011] [Revised: 11/10/2011] [Accepted: 01/09/2012] [Indexed: 11/18/2022] Open
Abstract
Aim. To evaluate the incidence and severity of postendodontic treatment pain (PEP) subsequent to root canal treatment (RCT) in vital and necrotic pulps and after retreatment. Methodology. A prospective study. Participants were all patients (n = 274) who underwent RCT in teeth with vital pulp, necrotic pulp, or vital pulp that had been treated for symptomatic irreversible pulpitis or who received root canal retreatment, by one clinician, during an eight-month period. Exclusion criteria were swelling, purulence, and antibiotic use during initial treatment. A structured questionnaire accessed age, gender, tooth location, and pulpal diagnosis. Within 24 h of treatment, patients were asked to grade their pain at 6 and 18 hours posttreatment, using a 1–5 point scale. Results. RCT of teeth with vital pulp induced a significantly higher incidence and severity of PEP (63.8%; 2.46 ± 1.4, resp.) than RCT of teeth with necrotic pulp (38.5%; 1.78 ± 1.2, resp.) or of retreated teeth (48.8%; 1.89 ± 1.1, resp.). No statistical relation was found between type of pain (spontaneous or stimulated) and pulp condition. Conclusion. RCT of teeth with vital pulp induced a significantly higher incidence and intensity of PEP compared to teeth with necrotic pulp or retreated teeth.
Collapse
|
22
|
Miani PK, do Nascimento C, Sato S, Filho AV, da Fonseca MJV, Pedrazzi V. In vivo evaluation of a metronidazole-containing gel for the adjuvant treatment of chronic periodontitis: preliminary results. Eur J Clin Microbiol Infect Dis 2011; 31:1611-8. [PMID: 22138847 DOI: 10.1007/s10096-011-1484-7] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2011] [Accepted: 10/29/2011] [Indexed: 11/26/2022]
Abstract
The present study developed an experimental metronidazole-based gel and evaluated its efficacy for the adjuvant treatment of chronic periodontitis. Sixteen patients were randomly allocated into two groups of eight subjects according to the following proposed treatments: (1) scaling and root planing (active control) or (2) scaling and root planing and direct periodontal intrapocket application of 15% metronidazole-based gel in two sites (≥5 mm in depth) (experimental group). Potential changes in the subgingival microbiota were assessed using a DNA Checkerboard method at three proposed times: baseline and following 7 or 30 days of drug administration. High-performance liquid chromatography (HPLC) monitored metronidazole concentrations in the crevicular fluid during treatment. The metronidazole experimental group presented lower bacterial counts than the control group at the three evaluated times (p<0.01 for baseline, p<0.001 for 7 or 30 days) when the target species were analyzed as a pool of bacteria. Samples revealed significantly lower counts 7 days after drug administration compared with baseline or after 30 days (p<0.05). HPLC analysis detected gel 1 h after application. The metronidazole-based gel significantly decreased the total bacterial count at the three evaluated times. Periodontopathogenic species were not different after gel administration.
Collapse
Affiliation(s)
- P K Miani
- Department of Dental Materials and Prosthodontics, School of Dentistry of Ribeirão Preto, University of São Paulo, Av. do Café, s/n°-Monte Alegre, Ribeirão Preto, SP, 14040-904, Brazil
| | | | | | | | | | | |
Collapse
|
23
|
D'Ercole S, Tetè S, Catamo G, Sammartino G, Femminella B, Tripodi D, Spoto G, Paolantonio M. Microbiological and Biochemical Effectiveness of an Antiseptic Gel on the Bacterial Contamination of the Inner Space of Dental Implants: A 3-Month Human Longitudinal Study. Int J Immunopathol Pharmacol 2009; 22:1019-26. [DOI: 10.1177/039463200902200417] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Microbial penetration inside the implant's internal cavity produces a bacterial reservoir that is associated with an area of inflamed connective tissue facing the fixture-abutment junction. The aim of this clinical trial is to evaluate the effectiveness of a 1% chlorhexidine gel on the internal bacterial contamination of implants with screw-retained abutments and on the level of AST secreted in peri-implant crevicular fluid. Twenty-five patients (aged 29 to 58 years) each received one implant. Three months after the end of the restorative treatment, and immediately after a clinical and radiographic examination and the abutment removal, microbiological samples were obtained from the internal part of each fixture and biochemical samples were collected by peri-implant sulci. The patients were then divided into two groups: the control (CG; n=10) and test (TG; n=15) groups. The CG had the abutment screwed into place and the crown cemented without any further intervention. In contrast, before the abutment placement and screw tightening, the TG had the internal part of the fixture filled with a 1% chlorhexidine gel. Three months later, the same clinical, microbiological and biochemical procedures were repeated in both groups. Total bacterial count, specific pathogens and AST activity were detected. The clinical parameters remained stable throughout the study. From baseline to the 3-month examination, the total bacterial counts underwent a significant reduction only in the TG. In contrast, the AST activity showed a significant increase in the CG. The administration of a 1% chlorhexidine gel appears to be an effective method for the reduction of bacterial colonization of the implant cavity and for safeguarding the health status of peri-implant tissue over a 3-month administration period.
Collapse
Affiliation(s)
| | - S. Tetè
- Department of Oral Sciences, School of Dentistry, “G. d'Annunzio”, University of Chieti-Pescara, Chieti
| | | | - G. Sammartino
- Department of Dental and Maxillo-Facial Sciences, University Federico II, Naples, Italy
| | - B. Femminella
- Department of Oral Sciences, School of Dentistry, “G. d'Annunzio”, University of Chieti-Pescara, Chieti
| | - D. Tripodi
- Department of Oral Sciences, School of Dentistry, “G. d'Annunzio”, University of Chieti-Pescara, Chieti
| | - G. Spoto
- Department of Oral Sciences, School of Dentistry, “G. d'Annunzio”, University of Chieti-Pescara, Chieti
| | - M. Paolantonio
- Department of Oral Sciences, School of Dentistry, “G. d'Annunzio”, University of Chieti-Pescara, Chieti
| |
Collapse
|
24
|
Ozçaka O, Biçakçi N, Köse T. Effect of the menstrual cycle on pain experience associated with periodontal therapy. Randomized, pilot study. J Clin Periodontol 2005; 32:1170-4. [PMID: 16212579 DOI: 10.1111/j.1600-051x.2005.00841.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVES The aim of this pilot cross-over study was to compare preliminarily the pain perception of female patients undergoing periodontal debridement during menstrual or pre-menstrual phases (peri-menstrual period) with that observed during mid-menstrual phase (post-menstrual period). MATERIALS AND METHODS Twenty women with moderate-to-advanced chronic periodontitis and regular menstrual cycles were asked to complete Corah's Dental Anxiety Scale (DAS) during the first debridement visit. Patients were randomly assigned to receive their first debridement visit during either their peri-menstrual or post-menstrual period. Debridement was performed in bilateral quadrants of patients during the periods. Pain levels for each quadrant were assessed with a Visual Analogue Scale (VAS), after each debridement visit. RESULTS There was no significant correlation of order of treatment in the intensity of perceived pain during the periods (p<0.05). The median VAS scores were 22.0 and 15.2 mm in the peri-menstrual and the post-menstrual period, respectively. Increase in pain perception among females during their peri-menstrual period was significantly greater than their post-menstrual period (p<0.05). CONCLUSION No clinical conclusions can be drawn at this stage as this pilot study did not have a sufficiently broad population to generalize these observations to all female periodontal patients. Providing clinicians with information about patients' menstrual cycle during debridement can alter the pain experience.
Collapse
Affiliation(s)
- Ozgün Ozçaka
- Department of Periodontology, School of Dentistry, Ege University, Izmir, Turkey.
| | | | | |
Collapse
|